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Dihydroorotate Dehydrogenase (DHODH) Inhibitor- Target Population, Competitive Landscape, and Market Forecast - 2034

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  • Vidofludimus Calcium(IMU-838) : Immunic Therapeutics
  • JBZ-001: Jabez Bioscience

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JHS 25.06.23

Key Highlights:

  • DHODH inhibitors target mitochondrial pyrimidine synthesis, disrupting DNA production and selectively suppressing rapidly dividing cells. This mechanism underpins their therapeutic potential in autoimmune diseases and oncology by controlling pathological immune activation and tumor growth.
  • In recent years, DHODH inhibitors have emerged as a promising therapeutic approach in the treatment of chronic inflammatory and autoimmune conditions such as multiple sclerosis, ulcerative colitis, non-Hodgkin lymphoma (NHL), and others.
  • In the 7MM, the United States accounted for the highest number of prevalent cases of Multiple Sclerosis in 2024.
  • In 2024, Moderate-to-severe cases of Ulcerative colitis were reported at a higher number than mild cases in the United States.
  • The DHODH inhibitor landscape includes only leflunomide and teriflunomide (AUBAGIO, generic since 2023), with several novel agents in clinical development for autoimmune, cancer, and viral indications.
  • Vidofludimus calcium (Immunic Therapeutics) and JBZ-001 (Jabez Bioscience) are promising DHODH inhibitors in clinical development.
  • Vidofludimus calcium targets multiple sclerosis and ulcerative colitis with neuroprotective and anti-inflammatory effects, while JBZ-001 is in Phase I for advanced cancers, disrupting pyrimidine synthesis in tumor cells.

DelveInsight's "Dihydroorotate Dehydrogenase (DHODH) inhibitor- Target Population, Competitive Landscape, and Market Forecast - 2034" report delivers an in-depth understanding of the DHODH inhibitors, historical and competitive landscape as well as its market trends in the United States, EU4 (Germany, France, Italy, and Spain) and the United Kingdom, and Japan.

The DHODH inhibitors' market report provides current treatment practices, emerging drugs, market share of individual therapies, and current and forecasted 7MM DHODH inhibitors' market size from 2020 to 2034. The report also covers current DHODH inhibitors' treatment practices/algorithms and unmet medical needs to curate the best opportunities and assess the market's potential.

Geography Covered:

  • The United States
  • EU4 (Germany, France, Italy, and Spain) and the United Kingdom
  • Japan

Study Period: 2020-2034

Dihydroorotate Dehydrogenase (DHODH) Inhibitors Understanding and Treatment Algorithm

Dihydroorotate Dehydrogenase (DHODH) Inhibitors Overview

DHODH inhibitors are a class of drugs that block the DHODH enzyme, a key player in the de novo synthesis of pyrimidines-molecules essential for DNA and RNA production. This enzyme is located in the mitochondria and supports the rapid proliferation of cells by enabling nucleotide synthesis. By inhibiting DHODH, these drugs limit the availability of pyrimidines, leading to reduced DNA synthesis and cell cycle arrest, particularly affecting rapidly dividing cells.

These inhibitors are used primarily in diseases characterized by excessive immune activation or abnormal cell growth. In autoimmune conditions like rheumatoid arthritis and multiple sclerosis, they suppress the proliferation of overactive immune cells. In oncology, DHODH inhibitors are being studied for their potential to slow the growth of cancer cells, which heavily rely on nucleotide synthesis. Through this mechanism, DHODH inhibitors serve as a targeted approach to control pathological cell activity in various disorders.

Dihydroorotate Dehydrogenase (DHODH) Inhibitors Market Overview

In recent years, DHODH inhibitors have emerged as a promising therapeutic approach in the treatment of chronic inflammatory and autoimmune conditions such as multiple sclerosis, ulcerative colitis, rheumatoid arthritis, NHL, and others. Their ability to modulate immune responses by targeting de novo pyrimidine synthesis positions them as potential disease-modifying agents. Clinical data continues to support their utility across these indications, driving interest and investment in this drug class. As development progresses, DHODH inhibitors are increasingly viewed as valuable additions to the immunology pipeline.

Dihydroorotate Dehydrogenase (DHODH) Inhibitors Epidemiology

The epidemiology chapter of DHODH inhibitors in the report provides historical as well as forecasted epidemiology segmented as total cases in selected indications for DHODH inhibitors, total eligible patient pool in selected indications for DHODH inhibitors, and total treated cases in selected indications for DHODH inhibitors in the 7MM covering the United States, EU4 (Germany, France, Italy, and Spain), and the United Kingdom, and Japan from 2020 to 2034.

  • In 7MM, the total prevalent cases of multiple sclerosis in 2024 were approximately 1,287,000 out of which the highest prevalent cases of this disease were seen in the United States, which accounted for approximately 55% of the total prevalent pool.
  • In EU4 and the UK, Germany had the highest prevalent pool of multiple sclerosis in 2024, which accounted for approximately 20% of the total 7MM prevalent cases of multiple sclerosis.
  • As per DelveInsight analyst's assessments, there were more females affected than males by multiple sclerosis in the United States in 2024.
  • In the United States, the highest number of cases of ulcerative colitis was reported in the age group of 18-44 years in 2024.

Dihydroorotate Dehydrogenase (DHODH) Inhibitors Drug Chapters

The drug chapter segment of the DHODH inhibitors report encloses a detailed analysis of approved DHODH inhibitors, late-stage (Phase III and Phase II) DHODH inhibitors. It also helps understand the clinical trial details of DHODH inhibitors, expressive pharmacological action, agreements and collaborations, approval, and patent details, advantages and disadvantages of each included drug, and the latest news and press releases.

Marketed Dihydroorotate Dehydrogenase (DHODH) Inhibitors

The approved landscape of DHODH inhibitors is limited to two agents: leflunomide and its active metabolite teriflunomide. Leflunomide, available in generic form, is primarily used in rheumatoid arthritis. Teriflunomide, marketed as AUBAGIO, is approved for the treatment of multiple sclerosis and became available as a generic in 2023. Beyond these, no other DHODH inhibitors have received regulatory approval. Several novel compounds are in clinical development for autoimmune diseases, cancer, and viral infections, indicating growing interest in this target.

Emerging Dihydroorotate Dehydrogenase (DHODH) Inhibitors

Vidofludimus Calcium (IMU-838): Immunic Therapeutics

Vidofludimus calcium is a small molecule investigational drug in development as an oral next-generation treatment option for patients with multiple sclerosis and other chronic inflammatory and autoimmune diseases. The selective immune modulator activates the neuroprotective transcription factor nuclear receptor-related 1 (Nurr1), which is associated with direct neuroprotective properties. Additionally, Vidofludimus calcium is a highly selective inhibitor of the enzyme DHODH, which is a key enzyme in the metabolism of overactive immune cells and virus-infected cells. This mechanism is associated with the anti-inflammatory and anti-viral effects of Vidofludimus calcium.

IMU-838, is currently in Phase III and Phase II clinical trials for the treatment of relapsing and progressive multiple sclerosis, respectively, and has shown therapeutic activity in Phase II clinical trials in patients suffering from relapsing-remitting multiple sclerosis, progressive multiple sclerosis, and moderate-to-severe ulcerative colitis.

JBZ-001: Jabez Bioscience

JBZ-001, an orally bioavailable small-molecule DHODH inhibitor, was designed to disrupt de novo pyrimidine nucleotide biosynthesis, a critical pathway for cancer cell proliferation. By targeting DHODH, the rate-limiting enzyme in this pathway, JBZ-001 demonstrated the potential to induce cytotoxic effects in tumor cells, offering a promising new approach to cancer treatment. The development of JBZ-001 marks a significant milestone in Jabez Biosciences' "bench-to-bedside" academic collaboration, with the compound receiving FDA approval for a commercial Investigational New Drug (IND) application in 2024. Currently in Phase I of the developmental process for the treatment of patients with advanced solid and hematological malignancies.

Dihydroorotate Dehydrogenase (DHODH) Inhibitors Market Outlook

The global DHODH inhibitor market is poised for steady growth, fueled by the rising burden of autoimmune and inflammatory diseases, along with increasing interest in targeting metabolic pathways in oncology and Immunology. While only two agents-leflunomide and teriflunomide-are currently approved, a growing clinical pipeline featuring candidates from companies like Immunic Therapeutics, Jabez Bioscience, and others suggests expanded therapeutic potential beyond traditional autoimmune indications.

Key areas of development include multiple sclerosis, ulcerative colitis, rheumatoid arthritis, NHL, and even viral infections. As emerging DHODH inhibitors progress through clinical trials, the field is expected to evolve toward more selective and better-tolerated agents. Over the next few years, data from late-stage studies will clarify the clinical value of this class and potentially position DHODH inhibitors as a broader therapeutic platform across immunology and oncology.

Dihydroorotate Dehydrogenase (DHODH) Inhibitors Drugs Uptake

This section focuses on the uptake rate of potential approved and emerging DHODH inhibitors expected to be launched in the market during 2025-2034.

Dihydroorotate Dehydrogenase (DHODH) Inhibitors Pipeline Development Activities

The report provides insights into different therapeutic candidates in Phase III, Phase II, and Phase I. It also analyzes key players involved in developing targeted therapeutics. The presence of numerous drugs under different stages is expected to generate immense opportunity for DHODH inhibitors' market growth over the forecast period.

Pipeline Development Activities

The report covers information on collaborations, acquisitions and mergers, licensing, and patent details for DHODH inhibitor therapies.

KOL Views

To keep up with current and future market trends, we take Industry Experts' opinions working in the domain through primary research to fill the data gaps and validate our secondary research. Industry experts were contacted for insights on DHODH inhibitors' evolving treatment landscape, patient reliance on conventional therapies, patient therapy switching acceptability, drug uptake, along challenges related to accessibility.

DelveInsight's analysts connected with 20+ KOLs to gather insights; however, interviews were conducted with 10+ KOLs in the 7MM. Centers such as Washington University and others.

Their opinion helps understand and validate current and emerging therapy treatment patterns or DHODH inhibitors' market trends. This will support the clients in potential upcoming novel treatments by identifying the overall scenario of the market and the unmet needs.

Qualitative Analysis

We perform Qualitative and market Intelligence analysis using various approaches, such as SWOT analysis and Conjoint Analysis. In the SWOT analysis, strengths, weaknesses, opportunities, and threats in terms of gaps in disease diagnosis, patient awareness, physician acceptability, competitive landscape, cost-effectiveness, and geographical accessibility of therapies are provided.

Conjoint Analysis analyzes multiple approved and emerging therapies based on relevant attributes such as safety, efficacy, frequency of administration, route of administration, and order of entry. Scoring is given based on these parameters to analyze the effectiveness of therapy.

In efficacy, the trial's primary and secondary outcome measures are evaluated; for instance, in event-free survival, one of the most important primary outcome measures is event-free survival and overall survival.

Further, the therapies' safety is evaluated wherein the acceptability, tolerability, and adverse events are majorly observed, and it sets a clear understanding of the side effects posed by the drug in the trials. In addition, the scoring is also based on the probability of success, and the addressable patient pool for each therapy. According to these parameters, the final weightage score and the ranking of the emerging therapies are decided.

Market Access and Reimbursement

Reimbursement may be referred to as the negotiation of a price between a manufacturer and payer that allows the manufacturer access to the market. It is provided to reduce the high costs and make the essential drugs affordable. Health Technology Assessment (HTA) plays an important role in reimbursement decision-making and recommending the use of a drug. These recommendations vary widely throughout the seven major markets, even for the same drug.

In the US healthcare system, both Public and Private health insurance coverage are included. Also, Medicare and Medicaid are the largest government-funded programs in the US. The major healthcare programs including Medicare, Continuing Medical Education (CME) program, the Children's Health Insurance Program (CHIP), and the state and federal health insurance marketplaces are overseen by the Centers for Medicare & Medicaid Services (CMS). Other than these, Pharmacy Benefit Managers (PBMs), and third-party organizations that provide services, and educational programs to aid patients are also present.

The report further provides detailed insights on the country-wise accessibility and reimbursement scenarios, cost-effectiveness scenario of approved therapies, programs making accessibility easier and out-of-pocket costs more affordable, insights on patients insured under federal or state government prescription drug programs, etc.

Key Updates on Dihydroorotate Dehydrogenase (DHODH) Inhibitors

  • In May 2025, Jabez Biosciences, proudly shared the progress of its Phase I clinical trial for JBZ-001 (HOSU-53), a novel DHODH inhibitor, at the American Association for Cancer Research (AACR) Annual Meeting held April 25-30, 2025, at Chicago. The trial, conducted in collaboration with the Ohio State University Comprehensive Cancer Center, targets adults with advanced solid tumors and NHL.
  • In April 2025, Immunic Therapeutics announced that Vidofludimus calcium (IMU-838), a DHODH inhibitor, reduced the risk of disability worsening by 30% in patients with primary progressive multiple sclerosis in the phase II CALLIPER trial.
  • In September 2024, Immunic Therapeutics announced the presentation of key data at the 40th Congress of the European Committee for treatment and Research in Multiple Sclerosis (ECTRIMS), highlighting Immunic's lead asset, Vidofludimus calcium's (IMU-838) therapeutic potential in multiple sclerosis.

The abstract list is not exhaustive and will be provided in the final report.

Scope of the Report:

  • The report covers a segment of key events, an executive summary, and a descriptive overview of the DHODH inhibitors, explaining its mechanism, and therapies (current and emerging).
  • Comprehensive insight into the competitive landscape, and forecasts, the future growth potential of treatment rate, drug uptake, and drug information have been provided.
  • Additionally, an all-inclusive account of the current and emerging therapies and the elaborative profiles of late-stage and prominent therapies will impact the current landscape.
  • A detailed review of the DHODH inhibitors market, historical and forecasted market size, market share by therapies, detailed assumptions, and rationale behind our approach is included in the report, covering the 7MM drug outreach.
  • The report provides an edge while developing business strategies, by understanding trends, through SWOT analysis, expert insights/KOL views, and treatment preferences that help shape and drive the 7MM DHODH inhibitors market.

Dihydroorotate Dehydrogenase (DHODH) Inhibitors Report Insights

  • DHODH Inhibitors Targeted Patient Pool
  • Therapeutic Approaches
  • DHODH Inhibitors Pipeline Analysis
  • DHODH Inhibitors Market Size and Trends
  • Existing and future Market Opportunities

Dihydroorotate Dehydrogenase (DHODH) Inhibitors Report Key Strengths

  • 10 years Forecast
  • The 7MM Coverage
  • Key Cross Competition
  • Drugs Uptake and Key Market Forecast Assumptions

Dihydroorotate Dehydrogenase (DHODH) Inhibitors Report Assessment

  • Current Treatment Practices
  • Unmet Needs
  • Pipeline Product Profiles
  • Market Attractiveness
  • Qualitative Analysis (SWOT)

Key Questions:

  • What was the total market size of DHODH inhibitors, the market size by therapies, market share (%) distribution, and what would it look like in 2034? What are the contributing factors for this growth?
  • Which drug is going to be the largest contributor in 2034?
  • Which is the most lucrative market for DHODH inhibitors?
  • What are the pricing variations among different geographies for approved therapies?
  • How the reimbursement landscape has for DHODH inhibitors evolved since the first one was approved? Do patients have any access issues that are driven by reimbursement decisions?
  • What are the risks, burdens, and unmet needs of treatment with DHODH inhibitors? What will be the growth opportunities across the 7MM for the patient population of DHODH inhibitors?
  • What are the key factors hampering the growth of the market for DHODH inhibitors?
  • What are the indications for which recent novel therapies and technologies have been developed to overcome the limitations of existing treatments?
  • What key designations have been granted to the therapies for DHODH inhibitors?
  • What is the cost burden of approved therapies on the patient?
  • Patient acceptability in terms of preferred therapy options as per real-world scenarios?
  • What are the country-specific accessibility issues of expensive, recently approved therapies?

Reasons to buy:

  • The report will help develop business strategies by understanding the latest trends and changing dynamics driving the DHODH inhibitors market.
  • Understand the existing market opportunities in varying geographies and the growth potential over the coming years.
  • Distribution of historical and current patient share based on real-world prescription data along with reported sales of approved products in the US, EU4 (Germany, France, Italy, and Spain) the United Kingdom, and Japan.
  • Identifying strong upcoming players in the market will help devise strategies to help get ahead of competitors.
  • Detailed analysis and ranking of indication-wise current and emerging therapies under the conjoint analysis section to provide visibility around leading indications.
  • Highlights of access and reimbursement policies of approved therapies, barriers to accessibility of expensive off-label therapies, and patient assistance programs.
  • To understand Key Opinion Leaders' perspectives around the accessibility, acceptability, and compliance-related challenges of existing treatment to overcome barriers in the future.
  • Detailed insights on the unmet needs of the existing market so that the upcoming players can strengthen their development and launch strategy.

Table of Contents

1. Key Insights

2. Report Introduction

3. Executive Summary of Dihydroorotate Dehydrogenase (DHODH) Inhibitors

4. Key Events

5. Epidemiology and Market Forecast Methodology

6. Dihydroorotate Dehydrogenase (DHODH) Inhibitors Market Overview at a Glance in the 7MM

  • 6.1. Market Share (%) Distribution by Therapies in 2025
  • 6.2. Market Share (%) Distribution by Therapies in 2034
  • 6.3. Market Share (%) Distribution by Indications in 2025
  • 6.4. Market Share (%) Distribution by Indications in 2034

7. Dihydroorotate Dehydrogenase (DHODH) Inhibitors: Background and Overview

  • 7.1. Introduction
  • 7.2. Potential of Dihydroorotate Dehydrogenase (DHODH) Inhibitors in Different Indications
  • 7.3. Clinical Applications of Dihydroorotate Dehydrogenase (DHODH) Inhibitors

8. Target Patient Pool of Dihydroorotate Dehydrogenase (DHODH) Inhibitors

  • 8.1. Assumptions and Rationale
  • 8.2. Key Findings
  • 8.3. Total Cases of Selected Indication for Dihydroorotate Dehydrogenase (DHODH) Inhibitors in the 7MM
  • 8.4. Total Eligible Patient Pool of Selected Indication for Dihydroorotate Dehydrogenase (DHODH) Inhibitors in the 7MM
  • 8.5. Total Treatable Cases in Selected Indication for Dihydroorotate Dehydrogenase (DHODH) Inhibitors in the 7MM

9. Emerging Dihydroorotate Dehydrogenase (DHODH) Inhibitors

  • 9.1 Key Competitors
  • 9.2 Vidofludimus Calcium (IMU-838): Immunic Therapeutics
    • 9.2.1 Product Description
    • 9.2.2 Other Developmental Activities
    • 9.2.3 Clinical Development
    • 9.2.4 Safety and Efficacy
    • 10.2.5. Analyst Views
  • 9.3 JBZ-001: Jabez Bioscience
    • 9.3.1 Product Description
    • 9.3.2 Other Developmental Activities
    • 9.3.3 Clinical Development
    • 9.3.4 Safety and Efficacy
    • 9.3.5. Analyst Views

10 Dihydroorotate Dehydrogenase (DHODH) Inhibitors: Seven Major Market Analysis

  • 10.1 Key Findings
  • 10.2 Market Outlook of Dihydroorotate Dehydrogenase (DHODH) Inhibitors
  • 10.3 Conjoint Analysis of Dihydroorotate Dehydrogenase (DHODH) Inhibitors
  • 10.4 Key Market Forecast Assumptions of Dihydroorotate Dehydrogenase (DHODH) Inhibitors
    • 10.4.1 Cost Assumptions and Rebates
    • 10.4.2 Pricing Trends
    • 10.4.3 Analogue Assessment
    • 10.4.4 Launch Year and Therapy Uptakes
  • 10.5 Total Market Sizes of Dihydroorotate Dehydrogenase (DHODH) Inhibitors by Indications in the 7MM
  • 10.6 The United States
    • 10.6.1 Total Market Size of Dihydroorotate Dehydrogenase (DHODH) Inhibitors in the United States
    • 10.6.2 Market Size of Dihydroorotate Dehydrogenase (DHODH) Inhibitors by Indication in the United States
    • 10.6.3 Market Size of Dihydroorotate Dehydrogenase (DHODH) Inhibitors by Therapies in the United States
  • 10.7 EU4 and the UK
    • 10.7.1 Total Market Size of Dihydroorotate Dehydrogenase (DHODH) Inhibitors in EU4 and the UK
    • 10.7.2 Market Size of Dihydroorotate Dehydrogenase (DHODH) Inhibitors by Indications in EU4 and the UK
    • 10.7.3 Market Size of Dihydroorotate Dehydrogenase (DHODH) Inhibitors by Therapies in EU4 and the UK
  • 10.8 Japan
    • 10.8.1 Total Market Size of Dihydroorotate Dehydrogenase (DHODH) Inhibitors in Japan
    • 10.8.2 Market Size of Dihydroorotate Dehydrogenase (DHODH) Inhibitors by Indications in Japan
    • 10.8.3 Market Size of Dihydroorotate Dehydrogenase (DHODH) Inhibitors by Therapies in Japan

11 SWOT Analysis

12 KOL Views

13 Unmet Needs

14 Market Access and Reimbursement

15 Appendix

  • 15.1 Bibliography
  • 15.2 Report Methodology

16 DelveInsight Capabilities

17 Disclaimer

18 About DelveInsight

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